Inflammation-dependent and independent airway remodelling in asthma

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Arquivos
art_ELLIOT_Inflammationdependent_and_independent_airway_remodelling_in_asthma_2018.PDF (4.19 MB)
Citações na Scopus
48
Tipo de produção
article
Data de publicação
2018
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
ELLIOT, John G.
NOBLE, Peter B.
BAI, Tony R.
ABRAMSON, Michael J.
MCKAY, Karen O.
GREEN, Francis H. Y.
JAMES, Alan L.
Citação
RESPIROLOGY, v.23, n.12, p.1138-1145, 2018
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background and objective The pathology of asthma is characterized by airway inflammation (granulocytic (GA) or paucigranulocytic (PGA)) and remodelling of airway structures. However, the relationship between inflammatory phenotypes and remodelling is unclear. We hypothesized that some features of airway remodelling are dependent on granulocytic airway inflammation while others are not. Methods Post-mortem airway sections from control subjects (n = 48) and cases of asthma with (n = 51) or without (n = 29) granulocytic inflammation in the inner airway wall were studied. The thickness of the airway smooth muscle (ASM) layer, basement membrane and inner and outer airway walls, the size and number of ASM cells, the volume fraction of extracellular matrix within the ASM layer, ASM shortening and luminal mucus were estimated. Airway dimensions were compared between the three subject groups. Results In cases of PGA, only the thickness of the ASM layer and basement membrane was increased compared with control subjects. In cases of GA, not only the ASM and basement membrane were increased in thickness, but there was also increased inner and outer airway wall thickness and increased narrowing of the airway lumen due to ASM shortening and mucus obstruction, compared with control subjects. Granulocytic inflammation was observed more often in cases of fatal asthma. Conclusion These findings suggest that inner and outer wall thickening coexists with inflammation, whereas thickening of the ASM layer and basement membrane may be present even in the absence of inflammation. Remodelling of the ASM layer and basement membrane may therefore be less susceptible to anti-inflammatory therapy.
Palavras-chave
airway morphology, asthma, inflammation, stereology
URI
https://observatorio.fm.usp.br/handle/OPI/30905
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MPT
Artigos e Materiais de Revistas Científicas - LIM/05
Artigos e Materiais de Revistas Científicas - ODS/03